Synergistic effects of Chinese herbal medicine and biological networks

Chinese Herbal Medicine (CHM), an integral part of Traditional Chinese Medicine, has been implementing complex herbal formulae usually consisting of two or more medicinal herbs for the prevention and treatment of various diseases since antiquity. The key mechanisms of action of CHM for the systematic management of many diseases largely rely on the concept of synergy to reach an optimal clinical outcome with minimal side effects. With the development of the modern analytical tools and computational programs, a number of methodologies have been applied to evaluate the synergy among herbal ingredients and chemical constituents in CHM. In this chapter, we introduce the concept of synergy in CHM, review studies that investigated synergy of CHM for the management of cancer, diabetes, musculoskeletal pain, cardiovascular, inflammatory, hepatic, infectious and oxidative stress-related diseases. The complex synergistic interactions of CHM components in pharmacokinetics studies and biological networks are also discussed. Despite some of the scientific reports supporting the synergistic effects of multi-herbal and/or herb-drug combinations, the level of evidence remains low particularly in terms of their molecular mechanisms of action and clinical relevance. Significant challenges in the development of suitable methods for CHM synergistic studies are also mentioned.